Probiotics could help combat small intestinal bacterial overgrowth in patients with gastrointestinal cancer

Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria are present in the small intestine. Gastrointestinal cancer is related to compromised intestinal barrier function, reduced functionality of immune responses, and inadequate nutritional status, which impair the ability of patients to control intestinal bacterial proliferation. These result in conditions favourable to SIBO. However, the actual incidence of SIBO in patients with gastrointestinal cancer and its relation to clinical symptoms has not been explored.

A recent case-control study, led by Dr. Zhenjun Wu from the Department of Blood Transfusion and Clinical Laboratory at Qingdao University School of Medicine in Qingdao (China), has found that probiotics may combat SIBO in patients with gastrointestinal cancer and may alleviate some gastrointestinal symptoms.

The researchers evaluated 112 gastric and 88 colorectal cancer patients (aged 25-75 years). The control group consisted of 80 healthy volunteers (aged 20-65 years). Questionnaires were used to assess gastrointestinal symptoms and a glucose hydrogen breath test was used to determine SIBO status.

63.0% of patients with gastric and colorectal cancer versus 16.3% of controls tested positive for SIBO, which suggests that gastrointestinal cancer may be associated with SIBO. Besides this, proton pump inhibitor use in patients with gastrointestinal malignancies made SIBO more likely to occur.

In conclusion, SIBO’s prevalence is higher in patients with gastrointestinal cancer and a probiotic intervention for 4 weeks may combat SIBO in these patients, in addition to alleviating some of their gastrointestinal symptoms. Gastrointestinal symptoms in patients with gastrointestinal malignancies may possibly partially be because of SIBO and fits well with the processes likely to occur not only in such patients, but also in other intestinal oncological diseases.

Paul EnckProf. Dr. Paul Enck, Director of Research, Dept. of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany.
His main interests are gut functions in health and disease, including functional and inflammatory bowel disorders, the role of the gut microbiota, regulation of eating and food intake and its disorders, of nausea, vomiting and motion sickness, and the psychophysiology and neurobiology of the placebo response, with specific emphasis on age and gender contributions.
He has published more than 170 original data paper in scientific, peer-reviewed journals, and more than 250 book chapters and review articles. He is board member/treasurer of the European Society of Neurogastroenterology and Motility and of the German Society of Neurogastroenterology and Motility, and has served as reviewer for many international journals and grant agencies.

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